肝细胞癌组织miRNA-155水平变化及其对预后的影响

目的 观察肝细胞癌（HCC）组织miRNA-155水平变化,并分析其对患者预后的意义。方法 2013年1月~2014年5月我院诊治的50例HCC患者,取手术切除的癌组织,另取50例正常肝组织作为对照组,采用荧光定量PCR法检测组织miRNA-155水平。结果 正常肝组织miRNA-155水平（1.06±0.1）明显低于HCC癌组织,10例Ⅰ级、15例Ⅱ级、12例Ⅲ级和13例Ⅳ级HCC 组织miRNA-155水平分别为（2.04±0.82）、（3.02±1.20）、（4.20±1.84）和（6.24±2.36）;miRNA-155低水平HCC患者生存率（24.00%）明显高于miRNA-155高水平患者（9.24%,P<0.05）;在不同分级HCC（14.26月对9.02月）、不同肿瘤大小（15.68 月对10.02月）、肿瘤是否转移（8.20 月对14.46月）、是否静脉侵犯（9.36 月对14.36月）、肿瘤分化程度（15.20月对7.84月）和miRNA-155水平高低（7.86月对16.32月）患者间生存期均存在明显差异（P<0.05）;肿瘤大小（>5 cm,HR=1.46,P=0.038）、肿瘤转移（是,HR=1.72,P=0.026）、静脉侵犯（是,HR=1.46,P<0.001）、肿瘤分化（高分化,HR=1.33,P=0.012）和miRNA-155（高水平,HR=1.65,P<0.001）均为影响HCC患者预后的独立危险因素（P<0.05）。结论 肝癌组织miRNA-155水平明显高于正常肝组织,且高水平的miRNA-155为HCC患者预后的独立危险因素。结果表明,miRNA-155水平高低可评估HCC患者预后,可考虑将其作为评估HCC患者预后的独立预测因子之一。     

DR患者外周血趋化因子MIP-1α和MIP-1β水平变化的临床意义

目的：观察糖尿病视网膜病变患者外周血趋化因子巨噬细胞炎症蛋白-1α(macrophage inflammatory protein,MIP-1α)、MIP-1β水平变化,并分析其临床意义。

方法：选取佛山市第五人民医院和佛山市南海区第四人民医院收治的糖尿病无视网膜病变患者(DM组)、非增殖期糖尿病视网膜病变患者(NPDR组)和增殖期糖尿病视网膜病变患者(PDR组),各50例; 选取50例健康体检者作为对照组。观察不同组别患者外周血趋化因子MIP-1α、MIP-1β水平、血糖情况和细胞因子水平的差异,采用Pearson相关分析法分析糖尿病视网膜病变患者外周血趋化因子MIP-1α、MIP-1β水平与血糖和细胞因子水平的相关性。

结果：DM组患者的MIP-1α、MIP-1β和平均血糖(mean blood glucose,MBG)水平均高于对照组,差异有统计学意义(t=6.306、2.954、3.617,均P<0.05); DM组患者的胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、成纤维细胞生长因子-21(fibroblast growth factor-21,FGF-21)、血管内皮生长因子(VEGF)水平均高于对照组,差异有统计学意义(t=27.216、7.778、3.214,均P<0.05)。PDR组患者的MIP-1α、MIP-1β和MBG水平均高于NPDR组,差异有统计学意义(t=6.620、3.461、3.378,均P<0.05); PDR组患者的IGF-1、FGF-21、VEGF水平高于NPDR组,差异有统计学意义(t=10.260、12.611、4.108,均P<0.05)。糖尿病视网膜病变患者的MIP-1α、MIP-1β水平与MBG、IGF-1、FGF-21、VEGF水平呈正相关。

结论：增殖期糖尿病视网膜病变患者的MIP-1α、MIP-1β水平较高,且与血糖和细胞因子水平呈正相关。     

Astrocyte morphology: Diversity,plasticity, and role in neurological diseases

Astrocytes are the most abundant glial cells in the central nervous system (CNS) and participate in synaptic, circuit, and behavioral functions. The well‐developed protoplasmic astrocytes contain numerous processes forming well‐delineated bushy territories that overlap by as little as 5% at their boundaries. This highly complex morphology, with up to approximately 80% of the cell's membrane constituted by fine processes with dimensions on the tens of nanometer scale and high surface area to volume ratios, comes in contact with synapses, blood vessels, and other glial cells. Recent progress is challenging the conventional view that astrocytes are morphologically homogeneous throughout the brain; instead, they display circuit‐ and region‐specific morphological diversity that may contribute to the heterogeneous astrocyte‐neuron spatiotemporal interplay in different brain areas. Further, the fine structure of astrocytes is found to be highly plastic and activity‐dependent. We are beginning to understand how astrocyte structural plasticity contributes to brain functions. The change/loss of astrocyte morphology, traditionally known as a hallmark for reactive astrogliosis, is a common pathological feature in many neurological disorders. However, recent data suggest the fine structural deficits preceding reactive astrogliosis may drive disease progression. This review summarizes recent advances in astrocyte morphological diversity, plasticity, and disease‐related deficits.     

Predictive value of ultrasound-related scoring system on embryo development in early pregnancy after IVF/ICSI: An observation of embryonic quality

ObjectiveThis study aims to evaluate the value of the ultrasound-related scoring system on pregnant patients receiving assisted reproductive technology (IVF/ICSI) and early pregnancy outcome.Materials and methodsThis prospective study included 208 pregnant women receiving assisted reproductive technology (IVF/ICSI). The following ultrasound parameters were measured: gestational sac size, the proportion of the embryo and gestational sac (embryo/gestational sac), yolk sac size, and fetal cardiac activity. The above data were assigned according to the ongoing pregnancy rate (up to 14 weeks), and the score increased parallel to the pregnancy rate. All patients were grouped according to their scores.ResultsPatients with a score of 4–5 had a low ongoing pregnancy rate of 14.29%, while patients with a score of 6–7 had an ongoing pregnancy rate of 55.56%. Surprisingly, patients with a score of 8–9 had an ongoing pregnancy rate of 97.22%. In addition, it was found that the ongoing pregnancy rate was 100% (36/36) in patients with a score of 9. Conversely, there was no ongoing pregnancy in patients with a score of 4.ConclusionFirst, this scoring system is strongly associated with an ongoing pregnancy of over 14 weeks. Second, some reassurance can be given to patients with favorable ultrasound parameters, regardless of maternal age or previous pregnancy loss. Third, it would be meaningless to continue the pregnancy in patients with a score of 4, according to the scoring system. Fourth, patients without cardiac activity and embryos at days 33–35 after embryo transfer should discontinue the pregnancy, while patients with embryos should proceed with the pregnancy.     

Bone morphogenetic protein-7 represses hepatic stellate cell activation and liver fibrosis via regulation of TGF-β/Smad signaling pathway

BACKGROUND Liver fibrosis is a refractory disease whose persistence can eventually induce cirrhosis or even liver cancer.Early liver fibrosis is reversible by intervention.As a member of the transforming growth factor-beta(TGF-β)superfamily,bone morphogenetic protein 7(BMP7)has anti-liver fibrosis functions.However,little is known about BMP7 expression changes and its potential regulatory mechanism as well as the relationship between BMP7 and TGF-βduring liver fibrosis.In addition,the mechanism underlying the anti-liver fibrosis function of BMP7 needs to be further explored.AIM To investigate changes in the dynamic expression of BMP7 during liver fibrosis,interactions between BMP7 and TGF-β1,and possible mechanisms underlying the anti-liver fibrosis function of BMP7.METHODS Changes in BMP7 expression during liver fibrosis and the interaction between BMP7 and TGF-β1 in mice were observed.Exogenous BMP7 was used to treat mouse primary hepatic stellate cells(HSCs)to observe its effect on activation,migration,and proliferation of HSCs and explore the possible mechanism underlying the anti-liver fibrosis function of BMP7.Mice with liver fibrosis received exogenous BMP7 intervention to observe improvement of liver fibrosis by using Masson’s trichrome staining and detecting the expression of the HSC activation indicator alpha-smooth muscle actin(α-SMA)and the collagen formation associated protein type I collagen(Col I).Changes in the dynamic expression of BMP7 during liver fibrosis in the human body were further observed.RESULTS In the process of liver fibrosis induced by carbon tetrachloride(CCl4)in mice,BMP7 protein expression first increased,followed by a decrease;there was a similar trend in the human body.This process was accompanied by a sustained increase in TGF-β1 protein expression.In vitro experiment results showed that TGF-β1 inhibited BMP7 expression in a time-and dose-dependent manner.In contrast,high doses of exogenous BMP7 inhibited TGF-β1-induced activation,migration,and proliferation of HSCs;this inhibitory effect was associated with upregulation of pSmad1/5/8 and downregulation of phosphorylation of Smad3 and p38 by BMP7.In vivo experiment results showed that exogenous BMP7 improved liver fibrosis in mice.CONCLUSION During liver fibrosis,BMP7 protein expression first increases and then decreases.This changing trend is associated with inhibition of BMP7 expression by sustained upregulation of TGF-β1 in a time-and dose-dependent manner.Exogenous BMP7 could selectively regulate TGF-β/Smad pathway-associated factors to inhibit activation,migration,and proliferation of HSCs and exert antiliver fibrosis functions.Exogenous BMP7 has the potential to be used as an antiliver fibrosis drug.     

鼻咽癌腮腺淋巴结转移危险因素及高危患者腮腺局部调强放疗的探讨

目的 探讨鼻咽癌腮腺淋巴结转移的高危因素,评价高危者腮腺放疗的可行性。方法 收集2011-2017年江苏省肿瘤医院放疗科收治的440例初诊鼻咽癌患者的临床资料,回顾性分析腮腺淋巴结转移相关的影像特点、治疗及预后。全组采用调强放疗技术,全腮腺或部分腮腺照射、选择性PLN照射,X线和(或)电子线补量,剂量45~60 Gy。χ²检验或Fisher's精确概率法检验和单因素分析,Logistic回归模型多因素分析。Kaplan-Meier法生存分析,Logrank检验差异。结果 腮腺区影像学可见淋巴结者共230例。确诊腮腺转移11例(占2.5%,11/440),其中腮腺淋巴结最大径≥5 mm者占81.8%(9/11)。多因素分析显示Ⅱ区淋巴结包膜外侵为其转移的独立危险因素。将腮腺区淋巴结最大径≥5 mm、Ⅱ区淋巴结包膜外侵者筛选为腮腺淋巴结转移高危组,根据腮腺区是否放疗分为放疗组及未放疗组。生存分析发现,在230例患者中,高危组腮腺区放疗者与未放疗者无局部复发生存率不同(P<0.05),总生存、无远处转移生存、无进展生存均相近(P>0.05)。结论 鼻咽癌腮腺淋巴结转移率低,Ⅱ区淋巴结包膜外侵为其独立高危因素。对于腮腺淋巴结最大径≥5 mm,或腮腺区存在影像学可见淋巴结,即使其最大径<5 mm,但若合并Ⅱ区淋巴结包膜外侵,建议行腮腺区放疗。